Workplace-based screening for oral potentially malignant disorders: A systematic review and meta-analysis

BackgroundEmployees often remain underserved in healthcare due to demanding work schedules, limited access to services, and socioeconomic constraints. Risk-prone lifestyles further increase their vulnerability to oral potentially malignant disorders (OPMD) and oral cancer. Workplace-based screening represents a feasible and risk-based strategy for early detection and prevention. This review evaluated workplace-based OPMD screening by estimating prevalence and examining its role in early diagnosis and prevention of oral cancer.MethodsThe protocol was registered in PROSPERO (CRD42024574036). Comprehensive searches across major databases were performed using predefined eligibility criteria. Data were extracted after de-duplication. Study quality and risk of bias were assessed using Joanna Briggs Institute (JBI), Cochrane Risk of Bias in Non-Randomized studies of Exposure, and GRADEpro. A random-effects meta-analysis estimated pooled prevalence and associated risk factors.ResultsNineteen studies (1988-2024), predominantly cross-sectional, identified 4480 OPMDs among 30,358 screened workers, yielding a pooled prevalence of 17% (95% CI: 0.12-0.23) with substantial heterogeneity (I² = 99.3%). The pooled point estimates were above 1 for tobacco users and males; however, the 95% confidence intervals included 1, indicating that these associations were not statistically significant. The estimate for age was close to 1 and was also not statistically significant. Most studies showed low (n = 8) to moderate (n = 9) methodological quality (JBI) and low to very low certainty of evidence (Grading of Recommendations, Assessment, Development, and Evaluations), with marked publication bias.ConclusionNearly one-fifth of workers had an OPMD, with risks amplified by tobacco, age, and gender. Periodic workplace screening, awareness activities, intersectoral coordination, and a common risk factor approach are essential to strengthen oral cancer prevention.